Multidrug-resistant tuberculosis imported into low-incidence countries-a GeoSentinel analysis, 2008-2020
| Autor: | Eric Caumes, Martin P. Grobusch, Effrossyni Gkrania-Klotsas, Alexandre Duvignaud, Hilmir Asgeirsson, Lin H. Chen, Johannes Eimer, Elizabeth D. Barnett, Elena Trigo-Esteban, Davidson H. Hamer, Kristina M. Angelo, Mogens Jensenius, Christina Greenaway, Natasha S. Hochberg, Calvin Patimeteeporn, Maximilian Gertler |
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| Přispěvatelé: | Infectious diseases, AII - Infectious diseases, APH - Global Health, APH - Aging & Later Life, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medical migration Tuberculosis 030231 tropical medicine Antitubercular Agents MDR-TB Article 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine Epidemiology Tuberculosis Multidrug-Resistant medicine Humans extensively drug-resistant tuberculosis 030212 general & internal medicine Travel business.industry Public health Incidence (epidemiology) Incidence Extensively drug-resistant tuberculosis General Medicine Mycobacterium tuberculosis medicine.disease 3. Good health migrant Tropical medicine [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie epidemiology business Rifampicin medicine.drug immigration |
| Zdroj: | Journal of travel medicine, 28(6). Wiley-Blackwell Journal of Travel Medicine Journal of Travel Medicine, Wiley-Blackwell, 2021, ⟨10.1093/jtm/taab069⟩ J Travel Med |
| ISSN: | 1195-1982 1708-8305 |
| DOI: | 10.1093/jtm/taab069⟩ |
| Popis: | Background Early detection of imported multidrug-resistant tuberculosis (MDR-TB) is crucial, but knowledge gaps remain about migration- and travel-associated MDR-TB epidemiology. The aim was to describe epidemiologic characteristics among international travellers and migrants with MDR-TB. Methods Clinician-determined and microbiologically confirmed MDR-TB diagnoses deemed to be related to travel or migration were extracted from GeoSentinel, a global surveillance network of travel and tropical medicine clinics, from January 2008 through December 2020. MDR-TB was defined as resistance to both isoniazid and rifampicin. Additional resistance to either a fluoroquinolone or a second-line injectable drug was categorized as pre-extensively drug-resistant (pre-XDR) TB, and as extensively drug-resistant (XDR) TB when resistance was detected for both. Sub-analyses were performed based on degree of resistance and country of origin. Results Of 201 patients, 136 had MDR-TB (67.7%), 25 had XDR-TB (12.4%), 23 had pre-XDR TB (11.4%) and 17 had unspecified MDR- or XDR-TB (8.5%); 196 (97.5%) were immigrants, of which 92 (45.8%) originated from the former Soviet Union. The median interval from arrival to presentation was 154 days (interquartile range [IQR]: 10–751 days); 34.3% of patients presented within 1 month after immigration, 30.9% between 1 and 12 months and 34.9% after ≥1 year. Pre-XDR- and XDR-TB patients from the former Soviet Union other than Georgia presented earlier than those with MDR-TB (26 days [IQR: 8–522] vs. 369 days [IQR: 84–827]), while patients from Georgia presented very early, irrespective of the level of resistance (8 days [IQR: 2–18] vs. 2 days [IQR: 1–17]). Conclusions MDR-TB is uncommon in traditional travellers. Purposeful medical migration may partly explain differences in time to presentation among different groups. Public health resources are needed to better understand factors contributing to cross-border MDR-TB spread and to develop strategies to optimize care of TB-infected patients in their home countries before migration. |
| Databáze: | OpenAIRE |
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